After all, what looks like inefficiency to health care wonks looks like “income” to doctors. Defense contractors don’t like procurement reform, and when school systems try to reform their labor practices to better reward quality teaching, teacher’s unions tend to oppose it. Such is life. Incumbent stakeholders don’t like change, but when you have an inefficient system — like health care in the United States — it’s often very helpful to push change that incumbent stakeholders don’t like.

For these doctors, payment reform that prioritizes care quality and patient access to affordable coverage supersedes the issue of provider reimbursement. “What concerns physicians more than are they being paid enough is really what they’re being paid for,” DFA President Vivek Murthy explained:

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You know, right now we have a system that rewards volume and procedures and doesn’t necessarily reward quality of care or the time that physicians take to spend with their patients. I think what’s a priority for all physicians — whether they’re a generalist, whether a specialist, whether academic physicians or private physicians — is that we restructure payment in a way that does reward quality and does reward time spent with patients, and that’s the kind of system that we’d be willing to support

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Indeed, unlike a co-op or some kind of state based arrangement, a robust public option would not only drive down costs but also begin implementing payment system reforms that could help doctors deliver better care to their patients.